| Name: | Blood and Cancer Center, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 18 Jul 2001 (23 years ago) |
| Date of dissolution: | 19 Sep 2014 |
| Entity Number: | 000-217-837 |
| Register Number: | 000217837 |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Principal Address: | FLORENCE, AL |
| Registered Office Street Address: | 202 EAST DR HICKS BLVDFLORENCE, AL 35630 |
| Registered Office Street Address ZIP Code: | 35630 |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | $1,000 |
Activities
OWN/OPERATE A BLOOD/CANCER TREATMENT CENTER
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073567111 | 2006-05-22 | 2010-12-09 | 202 E DR HICKS BLVD, FLORENCE, AL, 356305768, US | 202 E DR HICKS BLVD, FLORENCE, AL, 356305768, US | |||||||||||||||||||||||||||||
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| Phone | +1 256-760-0422 |
| Fax | 2567600332 |
Authorized person
| Name | DR. ANTHONY J KALLIATH |
| Role | OWNER |
| Phone | 2567600422 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | AL14483 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | OTHER ID NUMBER-COMMERCIAL NUMBER |
| Number | 0133695 |
| Issuer | MEDICAID |
| Number | 051503257 |
| State | AL |
| Name | Role |
|---|---|
| KALLIATH, ANTHONY JACOB | Agent |
| Name | Role |
|---|---|
| KALLIATH, ANTHONY JACOB | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
